Families Find Hope In New Drug Not All Schizophrenics Will Be Able To Use It

March 19, 1988|By Ines Davis Parrish of The Sentinel Staff

A new drug to treat schizophrenics is being hailed by families of the mentally ill and mental health professionals, but a deadly side effect will limit its use when it goes on sale in a few months.

Clozapine has sparked hope because it is the most effective drug of its kind to come along in several years, said Chuck Harmon, spokesman of the National Alliance for the Mentally Ill, a support group.

But families have been cautioned that clozapine, to be marketed by Sandoz Research Institute in New Jersey as Clozaril, isn't for everyone.

The new drug can have a side effect -- a reduction in the infection- fighting white blood cells. Although the risk affects less than 1 percent of the patients on clozapine, it can lead to death if not caught early.

''It's very obvious why we're hopeful about this,'' said Florence Burke of Orlando, who has a schizophrenic son. ''When you've tried every other method and it doesn't work, you're willing to try anything.''

Adena DeReemer of Seminole County also wants the drug to become available. She would like to get her son off chlorpromazine, marketed as Thorazine, which is a widely used anti-psychotic that also acts as a tranquilizer.

''He's doing better now on Thorazine, but we're walking on eggs all the time,'' she said.

Clozapine is expected to receive approval from the federal Food and Drug Administration this summer and go on sale later this year. Gilbert Honigfeld, associate director of clinical research at Sandoz, said the drug will be available only to a small group for whom other treatment has failed.

La Amistad in Maitland, a private psychiatric center for adolescents, is applying to be one of the agencies to use the drug once it is distributed commercially, said administrator Ray Burns.

Schizophrenia, a mental disorder of unknown causes, affects about 1 percent of the population, or about 2 million people in the United States. Its symptoms include visual and auditory hallucinations, inappropriate emotional behavior and extreme withdrawal from society.

Clozapine is a promising drug because unlike most anti-psychotic chemicals, it is effective on the broad range of symptoms, Honigfeld said.

Patients who were hallucinating, withdrawn, sloppy or emotionally blank improved significantly on clozapine to the point of talking more, improving their appearance and picking up old hobbies or interests, Honigfeld said.

The drug also does not cause some of the side effects associated with most other anti-psychotic medications, such as trembling, rigid muscles and an involuntary, repetitious movement of face and body muscles.

About 60 institutions in the United States administer the drug, widely used in Europe, on a ''compassionate'' basis for patients whose symptoms are especially bad or whose treatment is unsuccessful, Honigfeld said.

In Florida, a few patients at the Anclote Manor Psychiatric Hospital in Tarpon Springs are on the drug. Medical director William Weber said patients in the research program did not improve on other treatment methods.

Ann Purcell, president of the Alliance for the Mentally Ill of Greater Orlando, has a son who is one of those patients. Purcell said she's ''guardedly optimistic'' about his success on clozapine, and added that she's noticed some improvements in the six weeks since he's been on the drug.

Honigfeld said home health agencies will control the distribution and weekly blood testing of patients who qualify for clozapine. He estimated about 5,000 to 10,000 patients in hospitals or group homes will qualify.

If patients show signs of problems with their white blood cells, they will be taken off the drug. If the side effect shows up, patients cannot be given clozapine again, Honigfeld said.

And that, he said, has caused heartache for parents whose children have done well on clozapine.

''Parents have begged us to find a way to keep their child on the drug,'' he said.

Honigfeld didn't know how much Clozaril will cost, but he said it will be expensive. For those who improve, it will be cost-effective because ''they will be able to leave the hospital and be treated as out-patients, which is at least half as expensive.''

He said some may be able to become functioning members of society, and that ultimately will benefit taxpayers.